2nd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 13-15 September 2000, Toronto, Canada

PREVALENCE OF LIPODYSTROPHY IN A COHORT OF ASIAN HIV PATIENTs

Antiviral Therapy 2000; 5(Suppl. 5):10 (abstract no. O15)

N Paton, J Aboulhab, Y-M Ng, F Karim and C-C Lee
Department of Infectious Diseases, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore

BACKGROUND: Previous cohort studies of lipodystrophy have largely been confined to Western populations and hence there is little data on Asian patients.

OBJECTIVES: To determine the prevalence of lipodystrophy in an Asian cohort.

DESIGN: We studied consecutive outpatients attending the national HIV referral centre in Singapore from March to May 2000. A structured questionnaire was administered asking about increases or decreases in fat in the face, neck, arms, breasts, abdomen, buttocks or legs. Lipoatrophy and fat accumulation were defined, respectively, by loss or gain of fat in one or more regions. Anthropometric parameters, multi-site skinfolds, segmental bioelectrical impedance, and fasting lipids and glucose were also measured.

RESULTS: We studied 410 patients, but for clarity of interpretation excluded 91 from the analysis due to wasting (> 10% weight loss) or recent opportunistic infection (previous 6 months). The 319 evaluable patients were predominantly male (85%) and of Chinese race (82%). At the time of study 30% were antiretroviral naïve, 34% were treated with NRTIs±NNRTI but were not receiving PIs, and 36% were on PI-containing regimens. The prevalence of lipoatrophy was similar in the naïve, non-PI and PI treatment groups (39, 39 and 43%; P=0.79), but fat accumulation (25, 34, and 53%; P<0.001) or mixed accumulation and atrophy (6, 7 and 18%; P=0.006) were reported significantly more often by the PI-treated patients.

CONCLUSIONS: Body shape changes were reported commonly in this group of mainly Chinese HIV patients. However, the high frequency of changes in treatment-naïve patients (even after excluding those with wasting and Ols) illustrates the difficulty of distinguishing treatment-related lipodystrophy from variations occurring as part of the disease course. PI treatment was significantly associated with fat accumulation or a mixed picture.

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O15

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